Monday, May 21, 2018

(LML) ILEP Learning Guides

Leprosy Mailing List – May 21,  2018

Ref.:    (LML) ILEP Learning Guides

From:  Annick Mondjo, Libreville, Gabon

Dear Pieter Schreuder,


In response to Dr. Paul Saunderson's first question on May 8, 2015, on the topic of the ILEP Learning Guides. I still got a working CD about Technical Publications (October 2005) called "ILEP Books". The total volume occupied by the files is 28.5 MB, of which 28.3 MB  for the fold of 93 pdf files in four languages (Français, English, Español, Português)


A zip file pdf will be sent separately in a second e-mail

I hope that it should meet the expectations of some colleagues and/or programmes.


Best regards

Dr Annick Mondjo

Directeur du Programme de Lutte

contre les Maladies Infectieuses

Ministère de la Santé et de la Famille

BP 50 Libreville


LML - S Deepak, B Naafs, S Noto and P Schreuder

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Wednesday, May 16, 2018

(LML) ILEP Learning Guides

Leprosy Mailing List – May 16,  2018

Ref.:    (LML) ILEP Learning Guides

From:  Verónica Mas, Fontilles, Spain

 Dear Colleagues,


The PDFs of ILEP Learning Guides are available in Spanish through Infolep. These are the titles:

·  ILEP Guía de Aprendizaje uno: Cómo diagnosticar y tratar la lepra. International Federation of Anti-Leprosy Associations. Londres: Federación Internacional de Asociaciones contra la Lepra (ILEP); 2002.

·  ILEP Guía de Aprendizaje dos: Cómo reconocer y tratar las reacciones leprosas. International Federation of Anti-Leprosy Associations. Londres: Federación Internacional de Asociaciones contra la Lepra (ILEP); 2003.

·  ILEP Guía de Aprendizaje tres: Procedimiento para efectuar una basciloscopia para la lepra. Groenen G, Saunderson PP, Ji B. Londres: Federación Internacional de Asociaciones contra la Lepra (ILEP); 2003.

·  ILEP Guía de Aprendizaje cuatro: Cómo prevenir las discapacidades en la lepra. International Federation of Anti-Leprosy Associations, Torres P. Londres: Federación Internacional de Asociaciones contra la Lepra (ILEP); 2006.

·  OMS/ILEP Guía Técnica de rehabilitación comunitaria y lepra: afrontando las necesidades de rehabilitación de las personas afectades de lepra y promocionando su calidad de vida. International Federation of Anti-Leprosy Associations. Londres: ILEP, OMS; 2007.

Kind regards,

Verónica Mas

Medical Library, Fontilles (Spain)


LML - S Deepak, B Naafs, S Noto and P Schreuder

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Tuesday, May 15, 2018

(LML) Are there any systematic reviews or evaluations of toolkits for challenging stigma?

Leprosy Mailing List – May 15,  2018

Ref.:    (LML)  Are there any systematic reviews or evaluations of toolkits for challenging stigma?

From:  Wim van Brakel, Amsterdam, the Netherlands

Dear Pieter and Bassey, 

Thanks to Bassey for the LML letter of April 25, 2018 with the question: "Are there any systematic reviews or evaluations of toolkits for challenging stigma?"  Sorry for this delayed response. I don't know of any reviews of toolkits. But that is perhaps because 'toolkits' is new fashion term. In the past we just called these 'interventions'. And there are plenty of reviews regarding stigma interventions, but I imagine you are familiar with most of these. You are right that evidence on effectiveness is still scarce.

The few reviews I know of are:


Heijnders, M L, and S Van der Meij. 2006. "The Fight against Stigma: An Overview of Stigma-Reduction Strategies and Interventions." Psychol.Health Med. 11 (1354–8506

Cross, H A, M L Heijnders, A K Dalal, S Sermrittirong, and S Mak. 2012a. "Interventions for Stigma Reduction – Part 1: Theoretical Considerations." Disability, CBR & Inclusive Development 22 (3).

Cross, H A, M L Heijnders, A Dalal, S Sermrittirong, and S Mak. 2012b. "Interventions for Stigma Reduction – Part 2: Practical Applications." Disability, CBR & Inclusive Development 22 (3):71–80.

Sermrittirong, S, W H van Brakel, J F G Bunders, G Unarat, and P Thanyakittikul. 2014. "The Effectiveness of De-Stigmatising Interventions." International Journal of Tropical Disease & Health 4 (12):1218–32.


Hofstraat, K, and W H van Brakel. 2016. "Social Stigma towards Neglected Tropical Diseases: A Systematic Review." International Health 8 (suppl 1):i53–70

Mental health:

Thornicroft, G, N Mehta, S Clement, S Evans-Lacko, M Doherty, D Rose, M Koschorke, R Shidhaye, C O'Reilly, and C Henderson. 2016. "Evidence for Effective Interventions to Reduce Mental-Health-Related Stigma and Discrimination." The Lancet 387 (10023):1123–32


Stangl, A L, J K Lloyd, L M Brady, C E Holland, and S Baral. 2013. "A Systematic Review of Interventions to Reduce HIV-Related Stigma and Discrimination from 2002 to 2013: How Far Have We Come?" J Int AIDS Soc 16 (3 Suppl 2):18734


Sommerland, N, E Wouters, E M H Mitchell, M Ngicho, L Redwood, C Masquillier, R Van Hoorn, S Van Den Hof, and A Van Rie. 2017. "Evidence-Based Interventions to Reduce Tuberculosis Stigma: A Systematic Review." INT J TUBERC LUNG DIS 21 (11):81–86

We are currently working under coordination of the NIH on a series of papers and reviews on health-related stigma that also include interventions. But these will not be available until later this year. 

I hope this helps!

With kind regards,



LML - S Deepak, B Naafs, S Noto and P Schreuder

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Monday, May 14, 2018

(LML) ILEP Learning Guides

Leprosy Mailing List – May 14,  2018

Ref.:    (LML) ILEP Learning Guides

From:  Henk Eggens, Santa Comba Dão, Portugal


Dear Pieter,


I also like to read old books. But guidelines should be as updated as possible.

Below is a list of ILEP publications and the years of their appearances. Most are over ten years old!


I think we should encourage ILEP to start the process of updating their excellent, but somewhat outdated guides.


Not only is this necessary because of the upcoming new WHO MDT regimen that were announced earlier this year. After the official WHO publication of these MDT guidelines, most country programmes will adopt these WHO guidelines sooner or later, I presume. This will have implications for rewriting some of the ILEP guides.

Moreover, it seems to me that, in the recent ten years or so, valuable lessons were learned in many aspects of clinical leprosy, leprosy control and related problems. These new insights also warrant an update of the guidelines.


Best regards,


Henk Eggens



ILEP Technical guides


Guidelines for the social and economic rehabilitation of people affected by leprosy, 1999

Facilitating the integration process, 2003

Stages and steps in the integration process, 2003

Training in leprosy, 2003



ILEP Learning guides


1: How to diagnose and treat leprosy, 2001

2: How to recognise and manage leprosy reactions, 2002

3: How to do a skin smear examination for leprosy, 2003

4: How to prevent disability in leprosy, 2006



ILEP Stigma guidelines


1: What is health-related stigma? 2011

2: How to assess health-­related stigma, 2011

3: A roadmap to stigma reduction: an empowerment intervention, 2011

4: Counselling to reduce stigma, 2011



Other ILEP publications


The interpretation of epidemiological indicators in leprosy, 2001

Technical guide on community-based rehabilitation and leprosy (WHO/ILEP), 2007

Triple Jeopardy: Tackling the discrimination facing girls and women with leprosy, 2015


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Sunday, May 13, 2018

(LML) World Leprosy Day 2018: How forward respecting the past?

Leprosy Mailing List – May 13,  2018

Ref.:  (LML)   World Leprosy Day 2018: How forward respecting the past?

From:  Ben Naafs, Munnekeburen, the Netherlands


Dear Pieter,


The Indian Journal of Medical Research invited me to write an editorial on the occasion of World Leprosy Day 2018. Beside feeling honoured and doubting my capability to do so, I felt it would give me the opportunity to voice my reflections on leprosy.


What I did not write is that we, as "leprologists", should consider whether it is reasonable to "treat" the 80% who cannot develop the disease, simply because they are leprosy contacts. It may be a waste of resources and exposes the "treated" to a potential risk. We need to find a way to detect the 20% who can, and then decrease the risk with a BCG-like vaccination.


A detection of the reprogramming of the host cell may give us this possibility (reprogramming and detection of the 20% explained in the article). Perhaps by presenting this to LML it may unleash a discussion on contact "treating", which, with the present knowledge, is one of the only ways in which we can achieve something good. This would then explain many of the questions which we have not been able to answer as today.





LML - S Deepak, B Naafs, S Noto and P Schreuder

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Saturday, May 12, 2018

(LML) ILEP Learning Guides

Leprosy Mailing List – May 12,  2018

Ref.:    (LML) ILEP Learning Guides

From:  Chris Schmotzer, Rawalpindi, Pakistan

Dear Pieter,

This is in reply to the queries raised by Paul Saunderson.

We are using the print copies of the ILEP Learning Guides a lot for leprosy training in dermatology.

We would be very grateful, if a CD with HD graphics for printing would be available as the quality of printing from the online source is not very good.

Kind regards,

Dr. Chris Schmotzer


Note Editor LML:

The ILEP Learning Guides have been translated in several languages as far as I know. For sure in Portugues (Brazil) as I was involved myself. I thought also in French (but I am not sure). If new editions of the ILEP Learning Guides are planned, attention to those guides should be given as well and new editions prepared!

LML - S Deepak, B Naafs, S Noto and P Schreuder

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Friday, May 11, 2018

(LML) HLA susceptibility locus for leprosy in medieval Europeans

Leprosy Mailing List – May 11,  2018

Ref.:    (LML) HLA susceptibility locus for leprosy in medieval Europeans

From:  Pieter AM Schreuder, Maastricht, the Netherlands

Dear Colleagues,


We like to refer to an interesting article: "Ancient DNA study reveals HLA susceptibility locus for leprosy in medieval Europeans". Krause-Kyora B, Nutsua M, Boehme L, et al. Nat Commun. 2018 May 1;9(1):1569. doi: 10.1038/s41467-018-03857-x.



Leprosy, a chronic infectious disease caused by Mycobacterium leprae (M. leprae), was very common in Europe till the 16th century. Here, we perform an ancient DNA study on medieval skeletons from Denmark that show lesions specific for lepromatous leprosy (LL). First, we test the remains for M. Leprae DNA to confirm the infection status of the individuals and to assess the bacterial diversity. We assemble 10 complete M. Leprae genomes that all differ from each other. Second, we evaluate whether the human leukocyte antigen allele DRB1*15:01, a strong LL susceptibility factor in modern populations, also predisposed medieval Europeans to the disease. The comparison of genotype data from 69 M. Leprae DNA-positive LL cases with those from contemporary and medieval controls reveals a statistically significant association in both instances. In addition, we observe that DRB1*15:01 co-occurs

with DQB1*06:02 on a haplotype that is a strong risk factor for inflammatory diseases today.


Download PDF



Best regards,



Pieter Schreuder



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Thursday, May 10, 2018

(LML) ILEP Learning Guides


Leprosy Mailing List – May 10,  2018

Ref.:    (LML) ILEP Learning Guides

From:  Richard de Soldenhoff, Edinburgh, Scotland


Dear Pieter and Paul,

I teach the Glasgow DTM&H students every year and am allocated about 2 to 2 and a half hours for Clinical Leprosy and Leprosy Control. I recall that I had Stanley Browne for 3 whole days in Liverpool in 1978!

It is obvious that a very cursory presentation is all that can be achieved in the short time available to me, which also includes some practical sessions on testing skin patches for sensory loss, palpation of peripheral nerves and a basic (Fritchi-style) VMT/ST.

However, I provide some handouts, the most important being a brief list of useful leprosy health learning materials (copy attached). I stress that the most useful are the 2 ILEP learning guides, which they may want to glance at in a free moment. Some of the students will never see a case of leprosy, but some of them will, and my main aim is to ensure that a small bell rings when a suspicious lesion presents itself. The ringing of the bell may then alert them to the need to look up the texts which they are aware of. I do not have copies of the CDs but do have copies of the printed versions.  I would be appalled if these extremely well written, necessary booklets were not available from the ILEP website. I do not consider other versions to be quite so essential.

With kind regards,


Dr Richard de Soldenhoff
42 Drummond Place
Edinburgh EH3 6NR
Scotland, UK
Tel (+44) 01315567979/07770751578

LML - S Deepak, B Naafs, S Noto and P Schreuder

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Wednesday, May 9, 2018

(LML) InfoNTD monthly mail with the latest publications on cross-cutting issues and NTDs – May 2018

Leprosy Mailing List – May 9,  2018

Ref.:  (LML) InfoNTD monthly mail with the latest publications on cross-cutting issues  and NTDs – May 2018

From:  Ilse Egers, Amsterdam, the Netherlands

Dear colleagues,


The newsletter provides you with a selection of news items and recent publications on cross-cutting issues in NTDs. Our starting point is to add articles covering a wide variety of issues. Unfortunately, this is not always possible due to a limited diversity in and shortage of articles on cross-cutting issues and NTDs.

Feel free to contact us with any questions or to receive the PDF if a link to the full text is not included. Our document delivery service is free!

Ilse Egers
InfoNTD Information officer




The world gears-up to eliminate sleeping sickness by 2020
Geneva −− An important meeting of national programme coordinators and stakeholders, which begins today at the headquarters of the World Health Organization (WHO), aims to further strengthen activities to achieve the elimination of human African trypanosomiasis as public health problem by 2020.






New publications



Visual impairment and risk of depression: A longitudinal follow-up study using a national sample cohort.
Choi HG, Lee MJ, Lee S-M. Sci Rep. 2018; 8(1).
Abstract The association of visual impairment and depression has been investigated in several studies based on a cross-sectional design, which cannot delineate temporal relationships. In the present study, we evaluated the influence of visual impairment on depression in all age groups using a longitudinal database of a national sample cohort from 2002 to 2013 provided by the Korean National Health Insurance Service. The risk of depression increased significantly in both the non-blindness visual impairment and blindness subgroups, with a higher HR in the blindness subgroup.
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Schistosomiasis in Zambia: a systematic review of past and present experiences.
Kalinda C, Chimbari MJ, Mukaratirwa S. Infect Dis Poverty. 2018; 7(1):41.
Background The speedy rate of change in the environmental and socio-economics factors may increase the incidence, prevalence and risk of schistosomiasis infections in Zambia. However, available information does not provide a comprehensive understanding of the biogeography and distribution of the disease, ecology and population dynamics of intermediate host snails.
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Neglected tropical diseases and equity in the post-2015 health agenda.
Taylor EM, Smith J. IDS Bull. 2018; 49(2):147-158.
Abstract Neglected tropical diseases (NTDs), a group of 17 or so diseases that disproportionately afflict the world's 'bottom billion', are a symbol of global health inequities, in terms of prioritisation, research attention, and treatment. This article traces efforts to include NTDs in the Sustainable Development Goal (SDG) agenda and, having achieved that goal, lobby for an influential position in the post-2015 aid agenda.
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Soil-transmitted helminthiasis among indigenous communities in Malaysia: Is this the endless malady with no solution?
Mohd-Shaharuddin N, Lim YAL, Hassan NA, et al. Trop Biomed. 2018; 35(1):168-180.
Abstract Soil-transmitted helminths (STHs) are the most common intestinal parasitic infections of medical importance in human. The infections are widely distributed throughout the tropical and subtropical countries including Malaysia particularly among disadvantaged and underprivileged communities. This study was conducted to determine the prevalence and pattern of STH infections among Temuan indigenous subgroup.
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Perception and incidence of Buruli ulcer in Ogun State, South West Nigeria: intensive epidemiological survey and public health intervention recommended.
Otuh PI, Soyinka FO, Nyemike Ogunro B, et al. Pan Afr Med J. 2018; 29.
Abstract Buruli ulcer (BU) is a highly ranked neglected tropical disease (NTD) of global health importance with increasing incidence in sub-Saharan Africa yet there is paucity of information on the epidemiology of BU in Nigeria. Incidentally, highly BU endemic Benin Republic shares proximity with Nigeria. This study was carried out to establish presence of BU and ascertain the level of BU perception among rural populace in Ogun State, south-west Nigeria.
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Surveillance for lymphatic filariasis after stopping mass drug administration in endemic districts of Togo, 2010-2015.
Dorkenoo MA, Bronzan R, Yehadji D, et al. Parasit Vectors. 2018; 11(1):244.
Abstract Togo is a country previously endemic for lymphatic filariasis (LF). In 2010, following nine years of mass drug administration (MDA) for LF, the country established a post-treatment surveillance (PTS) system. We present here the results of these PTS activities, carried out from 2010 to 2015, as well as the findings of follow-up investigations in 2016 to confirm the absence of infection in previously infected individuals.
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Socio-demographic determinants of dengue infection during an outbreak in Dar es Salaam City, Tanzania.
Camara N, Ngasala B, Leyna G, et al. Tanzan J Health Res. 2018; 20(2):1-7.
Abstract In recent years, the eastern coast of Africa has witnessed a number of dengue outbreaks. This study was carried out to determine socio-demographic determinants of dengue infection during the 2014 outbreak in Dar es Salaam, Tanzania.
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Decision support for evidence-based integration of disease control: A proof of concept for malaria and schistosomiasis.
Standley CJ, Graeden E, Kerr J, et al. PLoS Negl Trop Dis. 2018; 12(4):e0006328.
Abstract Designing and implementing effective programs for infectious disease control requires complex decision-making, informed by an understanding of the diseases, the types of disease interventions and control measures available, and the disease-relevant characteristics of the local community. Though disease modeling frameworks have been developed to address these questions and support decision-making, the complexity of current models presents a significant barrier to on-the-ground end users.
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Scaling down a deworming program among school-age children after a thirty-year successful intervention in the Bolivian Chaco.
Spinicci M, Macchioni F, Rojo D, et al. Trop. Med. Int. Health. 2018.
Abstract Preventive chemotherapy is the WHO-recommended control method for soil-transmitted helminthiases. In the Bolivian Chaco, 6-monthly single-dose mebendazole delivery to school-age children achieved a dramatic decrease in soil-transmitted helminthiases prevalence between 1987 and 2013. Consequently, in September 2016, preventive chemotherapy delivery was interrupted in 9 rural communities. In compliance with WHO recommendations, we intensified surveillance to monitor soil-transmitted helminthiases prevalence.
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Elimination of onchocerciasis from Colombia: first proof of concept of river blindness elimination in the world.
Nicholls RS, Duque S, Olaya LA, et al. Parasit Vectors. 2018; 11(1):237.
Abstract Onchocerciasis is a chronic parasitic infection originally endemic in 13 discrete regional foci distributed among six countries of Latin America (Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela). In Colombia, this disease was discovered in 1965 in the Pacific Coast of the country. This report provides the empirical evidence of the elimination of Onchocerca volvulus transmission by Simulium exiguum (s.l.) after 12 years of 6-monthly mass drug administration of Mectizan® (ivermectin) to all the eligible residents living in this endemic area.
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Impact of mass drug administration campaigns depends on interaction with seasonal human movement.
Gerardin J, Bertozzi-Villa A, Eckhoff PA, et al. Int Health. 2018:6.
Abstract Mass drug administration (MDA) is a control and elimination tool for treating infectious diseases. For malaria, it is widely accepted that conducting MDA during the dry season results in the best outcomes. However, seasonal movement of populations into and out of MDA target areas is common in many places and could potentially fundamentally limit the ability of MDA campaigns to achieve elimination.
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Status of lymphatic filariasis in five communities of Yorro Local Government Area, Taraba State, Nigeria.
Elkanah SO, Swemwua TC, Elkanah DS, et al. The Nigerian journal of parasitology. 2018; 39(1).
Abstract Lymphatic filariasis is a public health problem in the tropics. A study to determine the status of the disease in five rural communities was carried out in Yorro LGA. The study employed three methods namely, the standard parasitological techniques, Rapid assessment method and the use of structured questionnaire to collect socio-cultural data. A total of 327 night blood samples were collected using finger prick method and analysed.
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Mathematical modeling of lymphatic filariasis-schistosomiasis co-infection dynamics: Insight through public education.
Bonyah E, Okosun KO, Okosun OO, et al. International journal of ecology & development. 2018; 33(2).
Abstract In this paper, a mathematical model for Lymphatic Filariasis–schistosomiasis co-infection dynamics is explore to provide a theoretical mathematical analysis of Lymphatic Filariasis–schistosomiasis dynamics. The disease-free equilibrium is proved to be locally asymptotically stable when the respective epidemic basic reproduction number for the model is less than unity.
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Status of lymphatic filariasis with progression of age and gender & eradication strategies: A survey among residents of Hardoi district of Uttar Pradesh, an endemic region of North India.
Saeed M, Faisal SM, Ahmad I, et al. Cellular and molecular biology. 2018; 64(4):46-41.
Abstract Lymphatic filariasis (LF) is a chronic and debilitating disease that affects people in tropical and sub-tropical areas of Asia, Africa, and Western Pacific. This cross-sectional survey study was carried out in rural areas, where its inhabitants vary in socio-economic status, from low to middle-income class. 12 villages of Hardoi district, Uttar Pradesh, India were included. The aim was to see the impact of age and gender on various clinical forms of LF and in estimating its economic and social implications.
Read more




8th International Conference of the International Lymphoedema Framework
June 6-9, Rotterdam, The Netherlands
The principal topics for the conference will include: clinical diagnosis and assessment, self-management, epidemiology and pathophysiology, lymphoedema management, oncology rehab, national guidelines, outcome measures, and pediatric and primary lymphedema.

Snakebite: From Science to Society
June 21-22, Leiden, The Netherlands
Naturalis Biodiversity Center
Naturalis organises a 2-day international conference 'Snakebite : from science to society' to draw attention to a devastating, neglected tropical disease and to ignite international action on snakebite prevention and treatment. By bringing together science, government, industry and societal & humanitarian aid organisations, we want to take the first steps in developing solutions for the issues concerning snakebites in the tropics.



LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link:

Contact: Dr Pieter Schreuder <<